The first meta-analysis of domestic pharmacogenetic studies of clopidogrel

Introduction. A large number of scientific studies on the impact of CYP2C19 polymorphism in the pharmacogenetics of clopidogrel. The greatest evidentiary value shall be a meta-analysis, which absorbed a large number of research results. Unfortunately, the Russian exploration on the subject were not included in the coverage of international meta-analysis, due to the low quality of research and language barriers. This meta-analysis on the impact of CYP219 polymorphisms on the effectiveness clopidogrel therapy incorporates the results of Russian studies and is the first of its kind. Materials and methods. A literature search was conducted using electronic database Elibrary. The following included Russian mature patients (55-65 years) with IHD (such as in the form of angina pectoris and in the form of an acute coronary syndrome), which is assigned a dual antiplatelet therapy. Quantitative data synthesis performed using MIX Pro 2.0. The main criterion for distinction between the effect of the experimental and control groups was OR (odds ratio) for each of the outcomes. Uniformity analyzed studies was tested using Q-Cochran test. Among other things, in a meta-analysis examined the effect of the presence of polymorphism of CYP2C19*2 on the risk of thrombotic complications. Results. According to the results of three prospective studies presence of a polymorphism CYP2C19*2 significantly increased the risk of the end point of development in the form of complications such as cardiovascular death / MI / stent thrombosis / AI / TIA (OR=2,85, 95% CI 0,31-0, 78; p=0.01). The test for heterogeneity revealed no statistically significant differences between the results of studies (Q=1,71; p=0,77). Conclusions. As a result of Russia’s first meta-analysis on the impact of CYP2C19 polymorphism in the pharmacogenetics of clopidogrel it has been found that the presence of CYP2C19*2 polymorphism significantly increased risk of developing complications such as cardiovascular death / MI / stent thrombosis / AI / TIA.

meta-analysis, pharmacogenetics, clopidogrel, antiplatelet therapy, polymorphism, genotyping, allele, thromboembolic complications, bleeding, platelet activity

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